Post Cycle Therapy - Nolvadex, Clomid and HCG

One of the most frequently asked questions on MuscleTalk is how to use properly use the Post Cycle Therapy (PCT) drugs Nolvadex, Clomid and HCG correctly.

(A note to Americans - when I say 'oestrogen' I mean 'estrogen' - we spell it correctly in the UK!)

Why Bodybuilders Use ClomidClomid is a generic name for Clomiphene Citrate and is a synthetic oestrogen. It is prescribed medically to aid ovulation in low fertility females. Another generic name is Serophene.

Most anabolic steroids, especially the androgens, cause inhibition of the body's own testosterone production. When a bodybuilder comes off a steroid cycle, natural testosterone production is zero and the levels of the steroids taken in the blood are diminishing. This leaves the ratios of catabolic : anabolic hormones in the blood high, hence the body is in a state of catabolism, and, as a result, much of the muscle tissue that was gained on the cycle is now going to be lost.

Clomid stimulates the hypothalamus to, in turn stimulant the anterior pituitary gland (aka hypophysis) to release gonadotrophic hormones. The gonadotrophic hormones are follicle stimulating hormone (FSH) and luteinizing hormone (LH - aka interstitial cell stimulating hormone (ICSH)). FSH stimulates the testes to produce more testosterone, and LH stimulates them to secrete more testosterone. This feedback mechanism is known as the hypothalamic-pituitary-testes axis (HPTA), and results in an increase of the body's own testosterone production and blood levels rise, to, in part, compensate for the diminishing levels of exogenous steroids. This is vital to minimise post cycle muscle losses.

Not all steroids do cause shut down of the feedback mechanism. Everyone is different and you must also take into account how long you have been using a certain steroid and at what dose in order to determine if you need Clomid or not.

Clomid also works as an anti-oestrogen. As it's a weak synthetic oestrogen, it binds to oestrogen receptors on cells blocking them to oestrogen in the blood. This minimises the negative effects like gynecomastia and water retention that may be a result of oestrogen that has aromatised from testosterone.

It's effect as an anti-oestrogen are quite weak though, and it should not be relied upon if you are going to be using androgenic steroids that aromatise at a rapid rate, or if you are pre-disposed to gynecomastia. Arimidex and Nolvadex (Tamoxifen) are far more effective anti-oestrogens.

Important note: Clomid does not, as is often thought, stimulate the release of natural testosterone, but rather works at reducing the oestrogenic inhibition caused by the steroid cycle. It does this in a similar manner to the way it and Nolvadex block oestrogen receptors in nipples to combat gyno development, i.e. by blocking the oestrogen receptors in the hypothalamus and pituitary thus reducing the inhibition from the elevated oestrogen. This allows LH levels to return to normal, or even above normal levels, and in turn, natural testosterone levels to also normalise.

Inhibition of the HPTA is caused by either elevated androgen, oestrogen or progesterone levels. On cessation of the steroid cycle, androgen levels begin to fall and Clomid dosing is normally commenced according to the half-life of the longest acting drug in the system (see below).

This may also explain the reason individuals often find post-deca recovery more difficult, as the progesterone presence is untouched by the Clomid. We know that Clomid and Nolvadex (being very similar chemically) are both ineffective with regard to reducing progesterone related gyno, so it is reasonable to assume that Clomid has little effect against progesterone levels.

Clomid During A CycleWhen we use anabolic steroids, the level of androgens in the body rises causing the androgen receptors to become more highly activated, and through the HPTA, a signal tells our testes to stop producing testosterone. During a cycle the body has far higher than normal levels of androgens and, as long as this level is high enough, Clomid will not help to keep natural testosterone production up. It will be almost all but completely shut off, in theory.

Some heavy androgen users, however, do advocate a small burst of Clomid mid-cycle, though it must be hard for them to say if it really of any benefit, due to the amount of gear they are using. Therefore, the only purpose of Clomid during a cycle is as an anti-estrogen.

When To Take ClomidThe correct time to commence Clomid depends on the type and cycle of steroids you have been using. Different steroids have different half-lifes (indicates the time a substance diminishes in blood), and Clomid administration should be taken accordingly.

As we have seen above, Clomid taken when androgen levels in our blood are still high will be a waste. It is crucial to wait for androgen levels to fall before implementing our Clomid therapy. However, if taken too late we could possibly lose gains.

The list below determines when you should start Clomid. Select from the list any steroids you've used in your cycle and whichever one has the latest starting point is the time to commence Clomid. For example, if Dianabol, Sustanon and Winstrol were cycled, the time for administering Clomid should be 3 weeks post cycle, as Sustanon remains active in the body for the longest period of time.

Steroid

Time afterlast administration

Length ofClomid Cycle

Anadrol50/Anapolan50:

8 - 12 hours

3 weeks

Deca durabolan:

3 weeks

4 weeks

Dianabol:

4 - 8 hours

3 weeks

Equipoise:

17 - 21 days

3 weeks

Finajet/Trenbolone:

3 days

3 weeks

Primabolan depot:

10 - 14 days

2 weeks

Sustanon:

3 weeks

3 weeks

Testosterone Cypionate:

2 weeks

3 weeks

Testosterone Enanthate/Testaviron:

2 weeks

3 weeks

Testosterone Propionate:

3 days

3 weeks

Testosterone Suspension:

4 - 8 hours

2-3 weeks

Winstrol

8 - 12 hours

2-3 weeks

How To Take ClomidClomid has a long half-life (possibly 5 days), so there is no need to split up doses throughout the day. If Sustanon has been used and Clomid is commenced 3 weeks after the last injection, I would estimate that androgen levels are low enough to start sending the correct signals. If androgen levels are still a little high, we need to start at a high enough amount that will work or help, even if androgen levels are still a little high. Try 300mg on day 1; then use 100mg for the next 10 days; followed by 50mg for 10 days.

How to take Nolvadex for PCTAs an alternative to Clomid, which has been reported to have led to unwanted side effects such as visual disturbances in some users, Nolvadex can be employed. Nolvadex is a trade name for the drug Tamoxifen. Like Clomid, the half life of Nolvadex is relatively long enabling the user to implement a single daily dosing schedule. Administration would start as per the timescales outlined above and the duration would be identical to that of Clomid.

Typically, for a moderate-heavy cycle, the following dosages would be used:
Day 1 - 100mgFollowing 10 days - 60mgFollowing 10 days - 40mg

Occasionally, heavier cycles containing perhaps Nandrolone (Deca) or Trenbolone which by definition are particularly suppressive of the HPTA, may require a slightly longer therapy. Likewise, more modest/shorter cycles may require lower dosages, perhaps dropping each by 20mg per day.

Some users like to use both Clomid and Nolvadex in their PCT in an attempt to cover all angles. An example of the dosages involved might be:

Of course, the examples provided are not set in stone and may be adjusted depending on the factors outlined above and individual variances.

Using HCGIt is our opinion that HCG is probably one of the most misunderstood and misused compounds in bodybuilding. Hopefully this information will go some way towards rectifying that for the members of MuscleTalk. HCG stands for Human Chorionic Gonadotrophin and is not a steroid, but a natural peptide hormone which develops in the placenta of pregnant women during pregnancy to controls the mother's hormones. (Incidentally, this is the reason you may hear of people testing for growth hormone (HGH) with a pregnancy testing kit - If their HGH shows 'pregnant', they've been ripped-off with cheaper HCG - but we digress slightly).

Its action in the male body is like that of LH, stimulating the Leydig cells in the testes to produce testosterone even in the absence of endogenous LH. HCG is therefore used during longer or heavier steroid cycles to maintain testicular size and condition, or to bring atrophied (shrunken) testicles back up to their original condition in preparation for post-cycle Clomid therapy. This process is necessary because atrophied testicles produce reduced levels of natural testosterone, this situation should be rectified prior to post-cycle Clomid therapy.

HCG administration post-cycle is common practice among bodybuilders in the belief that it will aid the natural testosterone recovery, but this theory is unfounded and also counterproductive. The rapid rise in both testosterone, and thus oestrogen due to aromatisation, from the administration of HCG causes further inhibition of the HPTA (Hypothalamic/Pituitary/Testicular Axis - feedback loop discussed above); this actually worsens the recovery situation. HCG does not restore the natural testosterone production.

The typically observed dosing of 2000 to 5000IU every 4 to 5 days causes such an increase in oestrogen levels via aromatisation of the natural testosterone that this has been responsible for many cases of gynecomastia.

From the above discussion it is clear that HCG is best used during a cycle, either to:

HCG DosageSmaller doses, more frequently during a cycle will give best overall results with least unwanted side effects. Somewhere between 500IU and 1000IU per day would be best over about a two-week period. These doses are sufficient to avoid/rectify testicular atrophy without increasing oestrogen levels too dramatically and risking gynecomastia. This dosing schedule also avoids the risk of permanently down-regulating the LH receptors in the testes.

It is important for the HCG administration to have been completed with 6 or 7 clear days before the onset of PCT in order to avoid inhibition of the Nolvadex and/or Clomid therapy. Also, a small daily dose (10-20mg) of Nolvadex would normally be used in conjunction with HCG in order to prevent oestrogenic symptoms caused by sudden increases in aromatisation.

Presentation and Administration of HCGSynthetic HCG is often known as Pregnyl (generic name) and is available in 2500iu and 5000iu (not ideal for the above doses!). Administration of the compound is either by intra-muscular or subcutaneous injection. It comes as a powder which needs to be mixed with the sterile water. The powder is temperature-sensitive prior to mixing and should not be exposed to direct heat. After mixing, it should be kept refrigerated and used within a few weeks - though there are sterility issues which need to be considered after mixing.

Summary and Presentation of Clomid and HCGClomid and/or Nolvadex are more effective than HCG post cycle, but some long-term users like to use HCG during a cycle, or to prepare the testes for Clomid and/or Nolvadex therapy.

Clomid is available in 50mg tablets most commonly, but also comes in 25mg capsule, often in boxes of 24 tablets. Tamoxifen is made by a number of manufacturers and comes in 10mg or 20mg tablets, most commonly 30 x 20mg tablets. HCG generally comes in kits of three ampoules of powder needing to be mixed with the provided injectable water as 1500IU, 2500IU or 5000IU per ampoule kits.